Collaboration between ADB, JICA must be strengthened to achieve UHC: JICA President

Ensuring universal health coverage (UHC) is crucial to achieving the Sustainable Development Goals (SDGs) and targets under ADB’s Strategy 2030.

Asian Development Bank (ADB) President Mr Takehiko Nakao and Japan International Cooperation Agency (JICA) President Mr Shinichi Kitaoka today opened the “ADB-JICA Meeting on Achieving Universal Health Coverage in Asia and the Pacific” in Tokyo. Ensuring universal health coverage (UHC) is crucial to achieving the Sustainable Development Goals (SDGs) and targets under ADB’s Strategy 2030.

The meeting was held in the context of the G20 Summit, which will discuss UHC as a key topic. ADB and JICA have been partners in the health sector, as well as in infrastructure, climate change, education, and gender equality. Both institutions will help prepare concrete outcomes for UHC at the summit.

Today’s meeting gathers representatives from 25 countries, including health ministers and directors of regional public health institutes, to share global and regional experience in supporting UHC, and to discuss partnerships to bridge health care financing gaps, priority health issues including noncommunicable diseases (NCDs) and elderly care, and pandemic preparedness.

UHC is a key pillar of SDG 3 to ensure healthy lives and promote well-being for all at all ages. The World Health Organization defines UHC as ensuring that all people can use the health services they need, at sufficient quality, without being exposed to financial hardship.

Professor Keizo Takemi, a Member of Japan's House of Councillors and Special Committee on Health Security, emphasized the importance of health systems reforms in his keynote address. He discussed the old way of vertical treatments of individual diseases, stressed the special needs of ageing societies and the growing demand for treatments of NCDs, and recommended comprehensive horizontal approaches that treat the patient as a whole and not individual diseases to truly achieve UHC.

Mr Kitaoka said: “Collaboration between ADB and JICA should be strengthened in order to achieve UHC in this region by tackling the threat of communicable diseases as well as ageing society. Sharing all of our experiences and lessons, whether successful or unsuccessful, is one of our responsibilities in this region to advance UHC.”    

In his opening remarks, Mr Nakao said, “Under our new long-term Strategy 2030, in response to Asia and the Pacific’s growing needs for health services, ADB is scaling up our health sector operations with a focus on UHC.”

He discussed four critical challenges to achieving and maintaining UHC. First is a financially sustainable health system. The challenge of financing health is compounded by increasing longevity and ageing societies, which increase demands for financing. Technological development in health also incurs a greater cost per patient as more sophisticated equipment and medicine are used.

Developing countries can learn from the experiences of developed countries, including areas of needed improvement. A financially sustainable health system should have such elements as (i) a clear idea about who assumes the financial burden over the years, (ii) a good function by insurers to check efficiency, (iii) a system to monitor the effectiveness of medicine and treatments using broad data, and (iv) an incentive framework for patients and service providers for improved efficiency and cost saving.

Second is the growing burden of NCDs. When people live longer, there is a higher prevalence of NCDs. In addition to effective and efficient treatment and management, preventive measures including community-based health care and the encouragement of healthy behaviours are crucial.

The third challenge is health security. UHC must include disease surveillance and stronger laboratory capacity to check and prevent outbreaks of pandemics such as Severe Acute Respiratory Syndrome (SARS) at the early stage. Finally, health systems have the challenge and opportunity of using innovative technology such as the internet, digitalization, big data, and artificial intelligence, for the sustainability of health financing and better care depending on the individual situation of patients.

In 2018, ADB loan and grant commitments in the health sector totalled $516 million for 13 projects, the highest numbers for health since 2010. The projects included support for enhancing provincial-level health services in Papua New Guinea; the integration of maternal and child health services in Tajikistan; strengthening of health systems in Bhutan, Lao People’s Democratic Republic, Mongolia, and Sri Lanka; and investments in private hospitals that expand access to low-cost quality maternity care in Indonesia. 

In addition, ADB is providing technical assistance to help prepare national health strategies and build universal health care systems. ADB has been co-organizing conferences to promote the use of digital data in the health sector.